| Chacon Individual & Family Therapy, Llc | |
|
1313 Marron Cir Ne Albuquerque NM 87112-5035 | |
| (505) 315-7900 | |
| Not Available |
| Full Name | Chacon Individual & Family Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1313 Marron Cir Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Tracy Chacon (OWNER) |
| Authorized Official Contact | 5053157900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chacon Individual & Family Therapy, Llc 1313 Marron Cir Ne Albuquerque NM 87112-5035 Ph: (505) 315-7900 | Chacon Individual & Family Therapy, Llc 1313 Marron Cir Ne Albuquerque NM 87112-5035 Ph: (505) 315-7900 |
| NPI Number | 1669074902 |
|---|---|
| Provider Enumeration Date | 11/11/2020 |
| Last Update Date | 11/11/2020 |
| Certification Date | 11/11/2020 |
| Medicare PECOS PAC ID | 5799181392 |
|---|---|
| Medicare Enrollment ID | O20210907003479 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669074902 | NPI | - | NPPES |
| Provider Name | Tracy Chacon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962812412 PECOS PAC ID: 6002213584 Enrollment ID: I20211006000649 |
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